Lifting physically dependent individuals during patient transfers or completion of activities of daily living is a high volume/high risk activity in hospitals and other healthcare settings. Manualy lifting of patients is especially risky, for both the caregiver and patient. Healthcare institution have attempted to control the soaring costs associated with patient lifting injuries by investing i mechanical lift systems, proper lifting technique training, and zero lift policies. Yet the incidence of musculoskeletal injuries in the nursing professions remains at epidemic levels, consistently ranking near the top of all occupations. One reason for the continued prevalence of musculoskeletal injuries associated with patient handling relates to limitations of the currently available mechanical lifting devices, which utilize fabric slings or harnesses. These systems require a significant degree of manual manipulation of the patient (lifting, rolling) first to inset the sling, and afterwards to remove it. They also tend to be somewhat time consuming to utilize, discouraging compliance among time-constrained healthcare workers. The proposed study will focus on the development and evaluation of a sling-less alternative to current patient lift devices called 'Angel Hands'. Angel Hands is designed to operate seamlessly with overhead lift systems in VA Medical Centers, nursing homes, other healthcare facilities and private patient homes (though still far less prevalent than floor lifts and other transfer devices). Instead of a sling, Angel Hands uses curved, opposing mechanical arms, which gently close together beneath the patient. Powered belts that wrap around the top and bottom surfaces of each arm allow the hands to slip gently between the users' body and the surface upon which they are resting. A current Angel Hands prototype has shown considerable promise in its capacity to lift and transfer a person more quickly, simply, and with much less caregiver exertion than sling-based systems. In this study we will complete development and perform computer-based finite element analysis of the Angel Hands system, assembly the prototype and conduct extensive laboratory testing. Then, by means of focus groups and clinical trials, we will evaluate the technology in institutional settings, where its performance will be compared to conventional sling-based lift devices. We anticipate that the next generation of Angel Hands will perform very favorably in this comparison in terms of injury risk, usability and efficiency, and that this study will lead to definitive full scale clinical trials and subsequent commercialization. The adoption f Angel Hands in VA hospitals and nursing homes could revolutionize dependent patient care, by substantially reducing caregiver injuries as well as time devoted to patient handling tasks, and thus present substantial savings in healthcare costs to VHA. Other compelling potential benefits include enhanced independence for persons with disabilities who may be able to operate the device without assistance. PUBLIC HEALTH RELEVANCE: We propose to develop a next generation prototype of a sling-less lift technology, conduct extensive laboratory testing, and then evaluate by means of focus groups and clinical trials in hospital and nursing home settings, where its performance will be compared to conventional sling-based devices. We anticipate that the next generation of the prototype will perform very favorably in this comparison in terms of injury risk, usability and efficiency, and that this study will lead to an innovative solution for safe patient handling and movement.